Traditional burning ( medically known as traditional therapeutic burning, TTB) is Chinese moxibustion-like folk therapy, burning of sick people for healing purpose by using hot iron or actively burning firewood. It can be largely traumatizing and deep as well. As many as 70 burned spots can be sometimes counted on the skin of the victims.

Mostly the burns are inflicted on areas in proximity to a diseased organ in the body. For example if you complained headache, the most likely site in your body to be burned will be somewhere on your head, or in points related traditionally to the conceived origin of your problem. 

This relationship may be rooted in and historically related with old Arab medicine.
Traditional burning was traditionally believed not to pose a threat to the victims. However, many life threatening cases has been reported.

A tuberculosis patient burned with large hot metallic object called Sabarad

Traditional therapeutic burning is a very common practice in East Africa especially in Somali territories of Ethiopia, Kenya, Djibouti and Somalia. It’s a standard traditional treatment for almost any disease.

Interviews with local elders revealed a lot of details about this issue. These are some of the diseases they treat with roughly comparable modern clinical diagnosis:

-Facial palsy (or shimbir in Somali) 
-Hydrocephaly and rickets (madax faax) 
-Migraine headache (madax xanuun),
-Jaundice (cagaarshow)

Leg-deformity (dalbo), visceral leishmaniosis and many other local disease.
Each disease has its own number of burning spots and type of burning pattern. Some use hot sharp metallic objects of any sizes; others use specific type burning firewood.

Most importantly it’s believed that some traditional burning therapists have more healing power than others.This resulted in undercover commercial traditional burning system, making some therapists famous in villages. It involves hidden   payments and the trend is that  the healing power of burning  correlates with how much you make the burners ( therapist) happy, and there exists a referral system among the therapists. 

For example, the therapist says statements like “marwo  X markaan  curuurta ugubay 3000brr ayan kaqaadaye waxaad iigarato isii “,  roughly  meaning “when I burned the children of Mrs X, she paid Birr 3000. So give me what you can.”

This is a common word heard after undertaking  any burning session and the payment can’t be by any means less than the mentioned figure.

An old Somali adage roughly goes: burning and disease cannot stay together in a single body meaning burning removes illness.

Despite the prevalence of this practice, there are no scientific studies done on this issue. Nor are there reporting systems in regional or federal health bureaus. However, there are lots of complications reported by community elders and on the ground medical workers. 

The complications include infection at wound site(superinfection), bad and ugly scars especially in the face, and  internal organ perforation/damage. Even deaths have been reported due to overwhelming infection( sepsis).

A six years old boy with upper respiratory tract infection, burned in the four corners of the mouth, as he was struggling during burning (held by three strong adults). He was unintentionally burned inside mouth and tongue

This harmful traditional practice is one of the most unreported and most undocumented in the modern time. Proper scientific studies are very important to initiate local intervention and  to minimize morbidity.

TTB was rare in the past and remains even unheard of in the modern time. There appears to be no record of early physicians recognizing health importance of this cultural practice. Although the origin and history of the TTB is unknown, it’s believed to be part of ancient Arab and Egyptian traditional medicine.

An adult man with CLD (chronic liver disease) burned two occasions before coming to health facilities

Intervention Gap

There is increasing interest of researchers, humanitarian agencies and government policies, to discourage and show the ugly face of harmful traditional practices like FGM and early marriage and the likes to minimize its problem. But harmful traditional practices have many faces in different places and cultures and it seems that many dangerous practices  and traditions are still common in our societies. 

My suggestion is that as TTB is a harmful traditional practice (HTP), it should be grouped  with other HTPs like FGM,early marriage. Awareness creation at grassroots level in the public and warnings to burning therapist is just enough like any HTP.  There is huge money spent in this sector by federal and regional governments and NGOs each year.Therefore, solving TTB problem doesn’t demand additional expense.  

scientific gap

There is a little information known about TTB on present time and almost no single research done concerning this topic.

There is need to particularly determine the prevalence and associated complications of traditional therapeutic burning in the society of Somali state and east Africa at large. There is need to scientifically answer the questions why people go to traditional burning therapist before mainstream medical professionals? What are the magnitudes of this neglected harmful traditional practice? What is the driving interest of local traditional burning therapists to continuously burn people of their fellow human? Last but not least,, there is a research based need to forward the solution and pave the way of tackling this problem of “traditional kangaroo medicine”.

An important research proposal to answer the above question and to fill this scientific gap is in its final stage of development in Jigjiga University by a group of local doctors. I hope it will get approval soon.

Jigjiga University  is the only properly functioning university in the region as Kebridahar University is in  formation stage. So it is paramountly important to mobilize every resource to betterment of society. The research budget has to be tapped towards solving essential and indigenous problems of the region ( e.g. health, culture, economic, pastoral lives ) and forward solutions.

When I was a general practitioner working in the region, I found that  about 50 % of my patients were burned somehow before they come to my health facility. But I didn’t know  what name to use to describe this entity. I couldn’t simply call it burning. I have to differentiate it from accidental burn, not to say “abusive burn” the victims were 100% volunteers and willing to be burned. then I used this name “traditional therapeutic burning” to explain the new entity

Traditional: related with culture
Therapeutic: done for healing purpose
Burning: it’s an intentional burning using real fire

Dr Ahmed abdulahi